Epidemiology Commons^™

Impact Of Community Factors On The Donor Quality Score In Liver Transplantation, Giovanna Saracino

Walden Dissertations and Doctoral Studies

An increasing prevalence of metabolic syndrome and obesity has been linked to the rise in transplant indication for cryptogenic cirrhosis and nonalcoholic fatty liver disease (NAFLD), creating a growing challenge to public health. NAFLD liver transplant (LT) candidates are listed with low priority, and their waiting mortality is high. The impact of community/geographic factors on donor risk models is unknown. The purpose of this study was to develop a parsimonious donor risk-adjusted model tailored to NAFLD recipients by assessing the impact of donor, recipient, transplant, and external factors on graft survival. The theoretical framework was the social ecological model. Secondary …

Factors Affecting Breastfeeding In Preterm Infants, Evangeline Starks Glover

Walden Dissertations and Doctoral Studies

Even though initiation of breastfeeding among term and preterm infants has increased, the incidence and duration among preterm infants continues to lag because of the unique challenges of breastfeeding preterm infants. African American mothers have the lowest rates of breastfeeding initiation and duration, and their preterm infants are less likely to receive breast milk while in the neonatal intensive care unit. The objective of this cross-€sectional quantitative study was to evaluate the relationship between breastfeeding and maternal sociodemographic factors as well as medical and obstetrical conditions for infants born between 32-€37 weeks gestational age in South Carolina from 2009 to …

Health Awareness On High Blood Pressure, High Cholesterol, And Risk For Cardiovascular Disease, Innocent Bibi

Walden Dissertations and Doctoral Studies

Cardiovascular disease (CVD) is responsible for 25% of the annual deaths in the United States and represents a major public health burden, as patients often require screening and lifestyle changes related to multiple risk factors such as high blood pressure and high cholesterol. The purpose of this quantitative correlational study was to determine if there was a statistically significant association between high blood pressure and high cholesterol awareness (prevention and management) and cardiovascular health outcomes (angina pectoris, coronary heart disease, and heart attack). The theoretical framework that guided this study was the health belief model. Data from adults over the …

A Conflictive Triuvirate Consruct Of Epidemiologic Systems Failure, Ngozi Lois Ulinwa

Walden Dissertations and Doctoral Studies

Epidemiologic systems failure (ESF) is a major hurdle in minimizing the spread of infectious diseases during outbreaks. The reasons for ESF include the technical limitation of personnel handling epidemic crises, strictly defined health policies that limit the actions of epidemiologists, and personal perspective's reservations towards the intentions of health agencies. The purpose of this triumvirate mixed-methods case study was to examine factors of infectious disease control mechanisms useful for determining ESF. Three juxtaposed pre-emptive factors (technical [T], organizational [O], and personal [P] perspectives were used to determine how the multiple perspectives inquiring systems and fuzzy logic revealed factors causing ESF …

Efficacy Of A Minnesota Statute Enacted To Reduce Inflicted Traumatic Brain Injuries, Jonathan K. James

Walden Dissertations and Doctoral Studies

This quantitative research is on the efficacy of Minnesota Statute 144.574 enacted in 2005 in response to the growing awareness of behavior leading to inflicted Traumatic Brain Injuries (iTBI) in infants and children. The model for this research is grounded in the Theory of Reasoned Action wherein the education of new parents which graphically explains the physiologic changes to the structural architecture of the brain post-trauma, paired with their signature on a social contract (SC), demonstrated a reduction in incidence. Because the enacted statute does not include the signing of a SC, nor does it require face-to-face education as in …

Beliefs And Opinions Of Low-Income Residents Living In A Food Desert In A Gulf Coast State, Kimberly Lakeidra Willis

Walden Dissertations and Doctoral Studies

This study was an investigation of the access problem to fresh and affordable fruits and vegetables and how limited access influenced the beliefs and opinions of residents of a food desert as designated by United States Department of Agriculture. Many researchers have documented that price, availability, and transportation are barriers to fruit and vegetable consumption, particularly among low-income individuals. Researchers in other studies have concluded that these barriers are further exacerbated by an individual's distance from a supermarket or grocery store. However, much less information is available regarding the beliefs and opinions about life in a food desert and how …

"Exploring Telehealth Feasibility For Hiv Status In Individuals Aged 17 To 34 In Southwestern Nigeria", Michael Funso Olaniyi

Walden Dissertations and Doctoral Studies

Abstract

The use of smart phones among young people in Southwestern Nigeria has grown since the early 1990'€™s while traditional healthcare access had continued to deteriorate. HIV care centers have been concentrated in large cities, but earlier studies had shown higher prevalence of HIV in rural areas that constituted a larger portion of the population. However, existing studies had not adequately explored the use of mobile phones to supplement traditional healthcare access. The purpose of this study was to assess the feasibility of telehealth for healthcare access among individuals aged 17-34 with positive HIV status and those at high risk …

Relationship Between Elevated Blood Pressure/Hypertension In Military Personnel And The Stress Of Combat Deployment, Stephen James Pinkerton

Walden Dissertations and Doctoral Studies

Few studies about elevated blood pressure in the U.S. military exist in which researchers examined exposure to combat and its association with elevated blood pressure. The purpose of this quantitative research was to describe the extent of association between those who were exposed to combat deployment, were 40 or older, and were overweight or obese and had elevated blood pressure for U.S. military personnel who deployed to an area of declared combat between 2012 and 2017. The conceptual basis of this research was best represented by the determinants of health model. Chi-square correlation revealed that being older (equal to or …

Leptin Level Variance In Adults With And Without Cancer, Vilisa Chatman-Terry

Walden Dissertations and Doctoral Studies

Abstract

In 2018, health statistics revealed that, despite the many preventive measures established,

cancer was the second leading cause of death in the United States and the leading cause

of death in 22 states, exceeded only by heart disease. With obesity/leptin levels reaching

pandemic levels worldwide, and cancer having a well-known association with obesity,

both chronic diseases represent a large proportion of public health challenges. Guided by

the social ecological model, the purpose of this cross-sectional, quantitative study was to

examine if a significant difference exists in leptin levels among adults with different

types of obesity-associated and common cancers and …

The Effectiveness Of Two Types Of Adjunct Acupuncture Exposures On In Vitro Fertilization Outcomes, Lindsey Vacovsky

Walden Dissertations and Doctoral Studies

One out of every 8 couples experiences infertility. Few publications exist examining the association between the addition of adjunctive therapies when applied to the in vitro fertilization (IVF) procedure and pregnancy outcome. The purpose of this study was to compare the effectiveness of 2 types of adjunct acupuncture exposures on IVF outcomes by applying the concept of the epidemiology triad. The association between the type of adjunct acupuncture exposure received (the independent variable) and pregnancy (the outcome) was determined via binary logistic regression using SPSS software. Medical records of women having received the IVF procedure along with adjunct acupuncture were …

Feeding Practices And Nutritional Status Of Infants In Northwest Nigeria, Michael Enyi Enwere

Walden Dissertations and Doctoral Studies

Infants and young children in the Northwest province of Nigeria are susceptible to malnutrition. Inappropriate and inadequate breastfeeding and complementary feeding result in stunting, underweight, and wasting. The purpose of this cross-sectional study was to examine current feeding practices of infants not older than 2 years and their nutritional status in Northwest Nigeria. The theory of planned behavior was adopted in this research. With a total sample size of 3,861, multiple linear regression was adopted as a predictive analysis to delineate the correlation between two or more independent variables and one continuous dependent variable. Also, adopted was an independent t …

Socioeconomic Determinants Of Physical Activity Among Adult Arab Immigrants In Edmonton, Alberta, Samer Kobrosly

Walden Dissertations and Doctoral Studies

Little is known about leisure-time physical activity (LTPA) habits of Arab immigrants in Canada. Leisure-time physical activity has been linked to decreased risks for cancer, cardiovascular disease, and all causes mortality and increased life expectancy. Socioeconomic status has been recognized as a significant factor affecting health and wellbeing due to its impact on individuals’ attitudes, experiences, and exposure to several risk factors. The purpose of this cross-sectional descriptive study was to explore the levels of participation in LTPA among adult Arab immigrants in central Alberta, Canada, to examine the socioeconomic determinants of LTPA, and to investigate which individual, social, and …

Accessibility Of Innovative Services In Radiation Oncology, Patricia Sansourekidou

Walden Dissertations and Doctoral Studies

The field of radiation oncology (RO) involves the use of highly advanced techniques to treat cancer and safely spare healthy organs. The discipline has experienced rapid growth in the past 25 years, with technological advancement as the driving force. Available data and an instrument to effectively measure the accessibility of innovation in the field were lacking. The purpose of this study was to investigate the accessibility of innovative services in RO in the United States and assess possible diffusion patterns. Two hundred and forty medical physicists practicing in RO in the United States completed a custom Internet-based survey. The diffusion …

Family Predictive Factors Of Rural Malaria Prevalence In Nsukka, Eastern Nigeria, Gabriel Ugwuja Ugwu

Walden Dissertations and Doctoral Studies

Children in early childhood are still suffering from burdens of malaria-related morbidity and mortality. There have been insufficient studies on how family-level factors may predict the prevalence of malaria (PoM), and negatively impact the control of malaria in rural areas, especially among children. In this study, potential family factors were explored to address the challenges associated with the increase in PoM among the children in rural areas of Nsukka. Socioecological framework guided this study at the interpersonal level. The quantitative cross-sectional study used secondary data from Demographic and Health Surveys (DHS) of 2015 in Nsukka rural communities. Data were analyzed …

Factors Associated With Prostate Cancer Screening Intentions Among Adult Men In Nigeria, Ifeanyi N. Malu

Walden Dissertations and Doctoral Studies

Timely detection of prostate cancer (PCA) with prostate-specific antigens (PSA) and digital rectal examinations (DRE) are essential in optimizing incidence, minimizing prevalence, and reducing mortality rates. Given the low levels of participation in cancer screening, this study was conducted to examine the factors men consider when deciding whether to screen for PCA in Nigeria. A cross-sectional, online-based survey of 180 consenting Nigerian men 50 years old and older was carried out. Logistic regression analysis and descriptive statistics were used to analyze the data. Based on the data, there was a moderate positive association between the health belief model constructs and …

Impact Of Socioeconomic Status And Health-Seeking Behavior On Malaria In Pregnancy, Ifeanyi Livinus Udenweze

Walden Dissertations and Doctoral Studies

Malaria in pregnancy remains a public health challenge in Nigeria despite the fund appropriation for malaria control. The health challenges of malaria in pregnancy vary with populations and there is limited knowledge on the impact of the socioeconomic status and health-seeking behavior on malaria in pregnancy in Nigeria. The objective of this cross-sectional quantitative survey was to examine whether socioeconomic status and health-seeking behavior predict malaria in pregnancy in Nigeria using the social cognitive theoretical model. The data from a 2015 Nigeria Malaria Indicator Survey was used in this study. Data were analyzed using chi-square, binary, and multivariate logistics regression …

Trends In Prevalence And Predictors Of Undernutrition Among Children In South Central, Monica Kabahimba Zikusooka

Walden Dissertations and Doctoral Studies

Undernutrition is a global public health challenge. In Somalia, undernutrition is chronic with the situation often graded for emergency response. The purpose of this study was to provide contextual evidence regarding trends of prevalence and predictors of undernutrition in South Central Somalia. Following the UNICEF conceptual framework of determinants of undernutrition, the study examined which individual, household, and society factors were associated with undernutrition. Using secondary data from cross-sectional nutritional surveys implemented by the Somalia Food Security and Nutrition Analysis Unit from 2007 to 2012, a sample of 75,756 and 60,856 children aged 6-59 months was used in analyzing trends …

Adherence To Art Among Hiv Infected Female Sex Workers In Nigeria, Abass Babatunde Yusuf

Walden Dissertations and Doctoral Studies

A lack of adherence to antiretroviral therapy (ART) increases the risk of onward human immunodeficiency virus (HIV) transmission and mortality. The purpose of this cross-sectional study based on Andersen's conceptual framework was to test the associations between age, marital status, job/occupational status, education, membership in a peer support group, community, and facility ARV drug refill and alcohol and substance use, and adherence to ART among female sex workers (FSWs) who are 15 years and older in Rivers and Cross Rivers states Nigeria. Data were abstracted from existing program data collected between January 2015 and December 2017 by Heartland Alliance International, …

Effects Of Neighborhood Membership And Hypertensive Disorders In Pregnancy On Adverse Birth Outcomes, Chinyere Onyebuchi

Walden Dissertations and Doctoral Studies

Infant mortality (IM) rates in the United States remains high. The higher rates of IM among specific groups in the United States is believed to be fueled by the high rates of adverse birth outcomes including low birthweight (LBW) and preterm births (PTB) among these groups. Adverse birth outcomes have also been linked to the presence of hypertensive disorders during pregnancy. The purpose of this cross-sectional study was to explore the association between hypertensive disorders during pregnancy and adverse birth outcomes and the impact of the residential neighborhood of expectant mothers on this association. The life course health development theory …

Optimizing A Disease Severity Scale For Evaluating Travelers' Diarrhea In Adults, Nicole Maier

Walden Dissertations and Doctoral Studies

Primary efficacy endpoints for interventional products targeting travelers’ diarrhea (TD) prevention have been predominately based on stool frequency. However, reliance on stool-based endpoints alone may obscure potentially meaningful differences in illness profiles. A single, standardized scoring system optimized for use in adult travelers is needed to accurately measure TD severity and enable more robust estimates of treatment or intervention effectiveness. The purpose of this quantitative secondary data analysis was to describe the variability in TD signs and symptoms across traditional severity metrics such as stool output, identify which symptoms were significantly associated with a negative impact on activity, and determine …

Vitamin D Receptor Gene Polymorphisms Knowledge And Breast Cancer In Texas, Ejike Roland Egwuekwe

Walden Dissertations and Doctoral Studies

Breast cancer is a world health problem and is a leading cause of cancer-related death among women in the United States. However, breast cancer risks were reported to be reduced through exposure to Vitamin D through its Receptors identified as the p53 target gene. The purpose of this study was to assess the associations between VDR gene polymorphisms knowledge/awareness and decisions to reduce breast cancer risks and likelihood of mammogram screening among women in Texas. Data from survey were used. Roy adaptation model was the theoretical framework that guided this quasi- experimental, quantitative research. The dependent variables were decisions to …

Examining Relationships Between Sexual Education And Behaviors Among Virginia College Students, Dyani Meggett-Sowell

Walden Dissertations and Doctoral Studies

The college student population has a high prevalence of sexually transmitted infections (STI)s due to their participation in higher risk sexual behaviors such as serial relationships, drug and alcohol use and abuse, and inconsistent use of condoms. The purpose of this study was to examine the relationship between student exposure of sexual education and their sexual behaviors among college going students in Virginia. Guided by the health belief model, this quantitative cross-sectional study involved a random selection process to recruit college students to test the hypothesis. The research questions were designed to examine participants' exposure to sexual education, sexual behaviors, …

Smoking And Surgical Site Infection In Orthopedic Patients' Lower Extremity Arthroplasty, Alicia Y. Mingo

Walden Dissertations and Doctoral Studies

Cigarette smoking has been a public health concern for many years, and the possible impact of smoking on surgical site infection (SSI) has been studied broadly. However, a gap in understanding has persisted concerning whether there is an association between smoking tobacco and the development of SSI among patients who undergo lower extremity surgery, specifically total knee arthroplasty (TKA). The purpose of this study was to examine the association between smoking and lower extremity SSI. Andersen's behavioral model (BM) was used to understand the risk factors relevant to the interaction between smoking and SSI. Application of the BM categories of …

Connecticut Primary Care Physicians And Chronic Lyme Disease, Yvette P. Ghannam

Walden Dissertations and Doctoral Studies

The prevalence of chronic Lyme disease (CLD) remains relatively unknown in Connecticut because there is not an agreement on what CLD is and how it should be diagnosed in addition to which pathological agent causes CLD. The aim of this quantitative study was to assess whether there were significant differences between two groups of primary care physicians (PCP) working in Connecticut from two different points in time regarding their knowledge in the diagnosis, treatment, and management of CLD. A knowledge, attitude, and practice model was used as the underlying theoretical framework for this study. A random cross-sectional survey was mailed …

Evaluation By Geospatial And Spatiotemporal Distribution Of Tularemia Cases In Arkansas, Toni Kathleen Beavers

Walden Dissertations and Doctoral Studies

Tularemia is a vector-borne disease of global concern with diverse regional foci. Arkansas is an endemic state with differences in case distribution and land suitability supporting host and vector sustainment. The aim of this study was to conduct a geospatial and spatiotemporal assessment of factors associated with case distribution and timeliness and completeness of public reporting. Guided with direction from spatial epidemiology and nidality, referring to the association of ecology, climate, and proximity of disease, analysis included secondary data collected from the Arkansas Department of Health between 1995 and 2018. Using Poisson-based software, 2 clusters were found: a high-risk cluster …

Papanicolaou Test Status Among Inner-City Adolescent Girls In Accra, Ghana, Collins Kwesi Asamoa-Afriyie

Walden Dissertations and Doctoral Studies

Cervical cancer is an emerging public health problem in developing countries. Globally, it is the 3rd most common malignancy in women after breast and colorectal cancers and 4th most frequent cancer in women, with an estimated 570,000 new cases and 311,000 deaths in 2018. Cervical cancer screening in the developed countries is credited with the reductions in cervical cancer morbidity and mortality during the last 50 years. However, nearly 90% of cervical cancer deaths occur in less developed countries. Ghana has a cervical cancer rate of 26.4%. Further, it is the highest cancer incidence faced among women 25 to 44 …

Child Malnutrition In A Developing Country: A Persistent Challenge In Haiti, Jeanne M. Constant-Edma

Walden Dissertations and Doctoral Studies

Malnutrition is characterized by the insufficient intake of certain nutrients and the inability of the body to absorb or use these nutrients. This health problem continues to be a persistent challenge among children under 5 years of age in developing countries, including Haiti, despite food aid provided. The purpose of this study was to determine the association between dietary habits in children under 5 years of age in Haiti and their malnutrition status. Community organization theory was used to determine the association between determinants of health such as dietary habits, parents' knowledge and experience, cultural eating habits, socioeconomic status, and …

The Impacts Of Race, Residence, And Prenatal Care On Infant Mortality, Mary Christine Dorley

Walden Dissertations and Doctoral Studies

Tennessee ranks high for infant mortality (IM) in the United States. Despite public health efforts, the IM rate for Blacks is twice that of Whites mimicking what is observed nationally. Several risk factors for IM have been identified; however, it was still unclear how places of residence and prenatal care (PNC) affect IM for Tennesseans. The purpose of this study was to assess the relationship between places of residence (conceptualized by rurality and racial concentration), PNC, and IM among racial groups across Tennessee and to determine if race modified these associations. This was a cross-sectional study using data from the …

Factors Associated With Maternal Mortality In Greater Accra Ghana 2016: Case-Control Study, Edmund Sekyi Eghan

Walden Dissertations and Doctoral Studies

Maternal mortality is a critical area of concern globally, despite the availability of accessible preventive measures. The role of sociodemographic and service delivery factors in maternal mortality in the Accra Metropolitan Area of Ghana are important to examine. As part of the United Nations (UN) Millennium Campaign, the UN implemented 8 Millennium Development Goals (MDGs); maternal mortality reduction by 75% between 1990 and 2015 was among the fundamental MDGs to be achieved by 2015. The purpose of this case-control study was to use secondary data to assess the relationships between sociodemographic variables, service delivery factors, and maternal mortality among 8,171 …

Predictors Of Poor Pregnancy Outcomes Among Pregnant Women In Island Maternity, Nigeria, Letam Nwi-Ue

Walden Dissertations and Doctoral Studies

Pregnancy outcomes have improved tremendously in developed countries. Notwithstanding, it is still a huge challenge in developing countries, especially Sub-Saharan Africa. In 2015 in Nigeria, about 145 women died daily from pregnancy-related causes. Similarly, nearly 2,300 children under 5 years were lost in the same year. Nigeria consistently underperformed in some of the critical pregnancy indicators such as maternal and neonatal mortality, second worst only to India in the world. Studies on poor pregnancy outcomes are scarce in Nigeria. The purpose of this quantitative, retrospective cross-sectional study was to use local evidence to ascertain the risk factors that predict poor …